COR-CS-CS-F03

REVERSE CHARGE PICK UP REQUEST

Reminder!!!!
To 1st Request :
Branch 2nd Request :
From 3rd Request :
E-Mail rcharge@gdexpress.com
C.C
Date
FAX 03-77835133
PHONE : 03-7787 6677

Please pick up from ;

Please Tick :
Company
Address Document Parcel

Tel No
Contact person
Remark

Reverse charge pick up was requested from / to be deliver to :

Account No
Company
Address

Tel No
Contact person

Important Note :
All Reverse charge requests must be filled in with the account number
and must be e-mailed before 1.00pm ( Mon - Friday)
and before 10.00am for Saturday
** for certain areas, will need another day in advance. Please check with our Reverse Charge team
 COR-CS-CS-F03 Rev : 2

REVERSE CHARGE PICK UP REQUEST

Reminder:
To 1st Request
Branch 2nd Request
From 3rd Request

E-Mail gdexdsp@gdexpress.com
C.C
Date
FAX 03-7722 3730
PHONE : 03-7722 3400

Please pick up from

Please tick type of shipment :

Company
Address Document Parcel Cheque

TOTAL

ENHANCED LIABILITY COVERAGE (ELC) REQUIRED?

Tel No YES

Contact person NO

Remark ** Max liablity coverage without ELC per consignment note is RM200 only

Reverse charge pick up was requested & agreed by: For 3RD PARTY Reverse Charge Only:
** Reverse Charge surcharge will be applied

Account No RECEIVER'S ADDRESS

Company Company ______________________________

Address Address ______________________________

______________________________
______________________________
Company Chop Tel No ______________________________
Contact person ______________________________

Tel No ______________________________

Contact person

Important Note :
All Reverse charge requests must be filled in with the account number
and must be e-mailed or faxed before 12 noon ( Mon - Friday)
and before 10.00am for Saturday
** kindly reconfirm with our team if we have received fax accordingly
** for certain areas, will need another day in advance. Please check with our Reverse Charge team